Healthcare Provider Details

I. General information

NPI: 1760329775
Provider Name (Legal Business Name): TOMMY T NGUYEN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2026
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2828 NW 30TH ST
OKLAHOMA CITY OK
73112-7404
US

IV. Provider business mailing address

8608 NW 116TH ST
OKLAHOMA CITY OK
73162-2077
US

V. Phone/Fax

Practice location:
  • Phone: 405-945-8941
  • Fax:
Mailing address:
  • Phone: 580-340-9333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8210
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: